{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T06:27:19Z","timestamp":1790317639731,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Health Network and Sinai Health Geriatrics Summer Scholars Program and the Princess Margaret Cancer Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: Canada\u2019s aging population is leading to an increased number of older adults being diagnosed with cancer. This population faces unique challenges, including frailty, comorbidities, polypharmacy, and malnutrition, which can negatively affect treatment outcomes. The role of registered dietitians (RDs) in managing nutrition-related issues in this population is well-documented, but there is limited research on their integration into geriatric oncology clinics. We evaluated the impact of integrating a registered dietitian (RD) into the Older Adult with Cancer Clinic (OACC) at the Princess Margaret Cancer Centre, Toronto, Canada. Materials and Methods: A retrospective chart review was conducted of older adult cancer patients seen at the OACC, comparing outcomes before and after the RD\u2019s integration. The focus was on weight characteristics and change, malnutrition screening\/identification, and management. The two-item Canadian Nutrition Screening Tool (CNST) was introduced during the RD\u2019s integration and was also examined to see its usefulness in identifying malnutrition risk. Chi-squared tests and t-tests were used for data analysis. Results: The pre-cohort (n = 140) had a mean age of 80.2 years, 48.6% female, and 77.9% vulnerable (Vulnerable Elders Survey (VES-13) \u2265 3). The post-cohort (n = 117) had a mean age of 81.4 years, 59.8% female, and 80.3% vulnerable (VES-13 \u2265 3). Weight change within 3 \u00b1 1 months after the initial OACC consult was similar between pre and post groups with \u22121.4 kg and \u22121.2 kg, respectively (p = 0.77). Patients at nutritional risk, as determined by the OACC team, generated significantly more referrals to the RD in the post group (100% vs. 36.4%, p &lt; 0.001). Among patients who had CNST screening and saw the RD, there was a higher rate of high nutrition risk among CNST-positive compared to CNST-negative patients (67.2% versus 44.4%, respectively). After the integration of the RD, a greater number of patients at nutritional risk received nutritional education and referrals to other healthcare professionals (43 versus 1). Conclusions: The integration of an RD into the OACC led to improved referral rates, nutritional education, and referrals to other healthcare professionals. Moreover, patients who were CNST positive were more likely to have high nutritional risk.<\/jats:p>","DOI":"10.3390\/nu17091591","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T05:54:43Z","timestamp":1746510883000},"page":"1591","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Retrospective Analysis of the Impact of a Dietitian and the Canadian Nutrition Screening Tool in a Geriatric Oncology Clinic"],"prefix":"10.3390","volume":"17","author":[{"given":"Harriet","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Medicine, University Health Network, 200 Elizabeth Street Room EN14-214, Toronto, ON M5G 2C4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Cerullo","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5416-4196","authenticated-orcid":false,"given":"Rana","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Monginot","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-6046","authenticated-orcid":false,"given":"Shabbir M. H.","family":"Alibhai","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Health Network, 200 Elizabeth Street Room EN14-214, Toronto, ON M5G 2C4, Canada"},{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON M5G 2M9, Canada"},{"name":"Department of Medicine, Institute of Health Policy, Management, and Evaluation, and Institute of Medical Sciences, University of Toronto, 6 Queens Park Crescent West 3rd Floor, Toronto, ON M5S 3H2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"ref_1","first-page":"352","article-title":"Optimizing the Care of Older Canadians with Cancer and their Families: A Statement Articulating the Position and Contribution of Canadian Oncology Nurses","volume":"31","author":"Strohschein","year":"2021","journal-title":"Can. Oncol. Nurs. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/SPC.0000000000000740","article-title":"Real-world implementation of geriatric assessment in cancer care among older adults: The role of implementation science frameworks","volume":"19","author":"Blackberry","year":"2025","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4293","DOI":"10.1200\/JCO.23.00933","article-title":"Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update","volume":"41","author":"Dale","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1200\/JCO.2013.54.8347","article-title":"International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer","volume":"32","author":"Wildiers","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"496","DOI":"10.3322\/caac.21864","article-title":"Geriatric assessment for the practicing clinician: The why, what, and how","volume":"74","author":"Magnuson","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1200\/JCO.2018.78.8687","article-title":"Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology","volume":"36","author":"Mohile","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.jgo.2021.12.007","article-title":"The nutritional needs of older cancer survivors","volume":"13","author":"Kleckner","year":"2022","journal-title":"J. Geriatr. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101818","DOI":"10.1016\/j.jgo.2024.101818","article-title":"Association of malnutrition with geriatric assessment impairments and health-related quality of life among older adults with head and neck cancers","volume":"15","author":"Siwakoti","year":"2024","journal-title":"J. Geriatr. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"5147","DOI":"10.1002\/cncr.33122","article-title":"Association of malnutrition with geriatric assessment impairments and health-related quality of life among older adults with gastrointestinal malignancies","volume":"126","author":"Williams","year":"2020","journal-title":"Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7991","DOI":"10.1007\/s00520-022-07241-w","article-title":"The impact of nutrition on the lives of patients with digestive cancers: A position paper","volume":"30","author":"Vitaloni","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1038\/sj.bjc.6601962","article-title":"Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area","volume":"91","author":"Isenring","year":"2004","journal-title":"Br. J. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6947","DOI":"10.3390\/curroncol29100546","article-title":"Impact of Nutrition Counseling in Head and Neck Cancer Sufferers Undergoing Antineoplastic Therapy: A Randomized Controlled Pilot Study","volume":"29","author":"Dai","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.3945\/ajcn.111.018838","article-title":"Individualized nutrition intervention is of major benefit to colorectal cancer patients: Long-term follow-up of a randomized controlled trial of nutritional therapy","volume":"96","author":"Ravasco","year":"2012","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.clnesp.2020.10.023","article-title":"A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey","volume":"41","author":"Sullivan","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"7462940","DOI":"10.1155\/2019\/7462940","article-title":"Inadequate Nutrition Coverage in Outpatient Cancer Centers: Results of a National Survey","volume":"2019","author":"Trujillo","year":"2019","journal-title":"J. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"235","DOI":"10.6004\/jnccn.2021.7006","article-title":"The Impact of Early Referrals to Dietitians for Patients With Esophagogastric Cancer","volume":"19","author":"Roeland","year":"2021","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.jgo.2021.12.001","article-title":"Quality of care of consultations from the geriatric oncology clinic: \u201cAre we addressing the needs of patients?\u201d","volume":"13","author":"Chon","year":"2022","journal-title":"J. Geriatr. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1038\/ejcn.2014.270","article-title":"Validity and reliability of the new Canadian Nutrition Screening Tool in the \u2018real-world\u2019 hospital setting","volume":"69","author":"Laporte","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.jgo.2018.01.003","article-title":"Nutritional management of older adults with gastrointestinal cancers: An International Society of Geriatric Oncology (SIOG) review paper","volume":"9","author":"Mislang","year":"2018","journal-title":"J. Geriatr. Oncol."},{"key":"ref_20","unstructured":"Canadian Malnutrition Task Force (2025). Research\u2013Nutrition Care in Canada [Internet], Canadian Malnutrition Task Force. Available online: https:\/\/nutritioncareincanada.ca\/research."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"otab043","DOI":"10.1093\/crocol\/otab043","article-title":"Using Patient Completed Screening Tools to Predict Risk of Malnutrition in Patients With Inflammatory Bowel Disease","volume":"3","author":"Taylor","year":"2021","journal-title":"Crohns Colitis 360"},{"key":"ref_22","unstructured":"Canadian Taskforce on Anthropometric Measures (CTAN) (2025). Nourish: Nourishing Canada\u2019s Aging Population [Internet], Nourish. Available online: https:\/\/www.nourishonline.ca\/ctan\/."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: Clinical Nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/j.jgo.2020.12.002","article-title":"Role of the vulnerable elders survey-13 screening tool in predicting treatment plan modification for older adults with cancer","volume":"12","author":"Almugbel","year":"2021","journal-title":"J. Geriatr. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1016\/j.jgo.2018.03.012","article-title":"Beyond the black box of geriatric assessment: Understanding enhancements to care by the geriatric oncology clinic","volume":"9","author":"Alibhai","year":"2018","journal-title":"J. Geriatr. Oncol."},{"key":"ref_26","unstructured":"University Health Network (2019). Standards of Care: Clinical Nutrition Prioritization Matrix, University Health Network."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Richards, J., Arensberg, M.B., Thomas, S., Kerr, K.W., Hegazi, R., and Bastasch, M. (2020). Impact of Early Incorporation of Nutrition Interventions as a Component of Cancer Therapy in Adults: A Review. Nutrients, 12.","DOI":"10.3390\/nu12113403"},{"key":"ref_28","unstructured":"Cancer Care Ontario (2024). Appendix 1-45: CCO DBK, version 2, Cancer Care Ontario. Available online: https:\/\/quorum.hqontario.ca\/Portals\/0\/Users\/125\/53\/22653\/CCO_DBK_Appendix_1-45_APR_21(2).pdf."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1007\/s13668-024-00578-0","article-title":"The Importance of Nutrition in Cancer Care: A Narrative Review","volume":"13","author":"Soares","year":"2024","journal-title":"Curr. Nutr. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2050312120926877","DOI":"10.1177\/2050312120926877","article-title":"A review of nutrition and dietary interventions in oncology","volume":"8","author":"Gray","year":"2020","journal-title":"SAGE Open Med."},{"key":"ref_31","unstructured":"Princess Margaret Cancer Campus (2025). Malnutrition in Cancer Care [Internet], University Health Network. Available online: https:\/\/pmcancercampus.ca\/local\/courseinfo\/courseInfoPage.php?id=280."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/9\/1591\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:27:30Z","timestamp":1760030850000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/9\/1591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":31,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["nu17091591"],"URL":"https:\/\/doi.org\/10.3390\/nu17091591","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}